Evaluation of ultrasonography and clinical diagnostic scoring in suspected appendicitis.
BACKGROUND
Several diagnostic aids have been developed to improve diagnosis in suspected appendicitis including ultrasonography and clinical diagnostic scoring. The aim of this study was to elaborate a new scoring system and to measure its accuracy in the preoperative diagnosis of appendicitis, comparing it with the available scoring systems.


METHODS
The clinical, radiological and ultrasonographic data of 192 patients with suspected appendicitis were collected prospectively.


RESULTS
Only six of the 12 variables analysed were shown to have prognostic significance. Using Bayesian methodology, a weight was given to each criterion and two overall scores were calculated (ultrasonographic and classical scores). A cut-off point was identified to separate patients who needed surgery and those for observation. The ultrasonographic score showed an 81 per cent sensitivity and a 96 per cent specificity, compared with 60 and 73 per cent respectively for the classical score.


CONCLUSIONS
Ultrasonography increases the diagnostic accuracy in patients with suspected acute appendicitis.
Galindo Gallego
M
M
Department of Surgery, Hospital General de Segovia, Spain.
Fadrique
B
B
Nieto
M A
MA
Calleja
S
S
Fernández-Aceñero
M J
MJ
Ais
G
G
González
J
J
Manzanares
J J
JJ
D015746:Abdominal Pain / Q000000981:diagnostic imaging / Q000209:etiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001064:Appendicitis / Q000000981:diagnostic imaging*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014463:Ultrasonography